Drug-Coated Stents Reduce Repeat Artery Procedures

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The study was funded in part by the U.S. National Institute on Aging and is published in the June 25 issue of the Journal of the American Medical Association.

While drug-coated stents are now used in perhaps 70 percent of cases, the bare-metal kind has its uses, Malenka said. "We understand that patients who get drug-eluting stents have to be on two antiplatelet [clot-preventing] drugs for at least a year," he said. "Not everyone can be able to afford them or be compliant with their use."

Dr. Kirk Garratt, clinical director of interventional cardiovascular research at Lenox Hill Hospital's Heart and Vascular Institute in New York City, said the new study helps to establish the appropriate use of drug-coated stents.

"We went through a difficult period when it appeared there might be real problems with drug-eluting stents involving clot formation, leading to deaths and heart attacks," Garratt said. "We found that, in fact, there does not seem to be an important signal of risk with drug-eluting stents around the world."

The Dartmouth report is the latest in "half a dozen studies, all of which indicate the use of drug-eluting stents is perfectly safe and does yield an important reduction in the need for further procedures," Garratt said.

The study was done before a second coated stent, Boston Scientific Corp.'s paclitaxel-coated Taxus, was marketed. The U.S. Food and Drug Administration has just approved a third model, Medtronic's Endeavor, coated with zotarolimus, and other products are in the testing pipeline.

The Dartmouth study differed in one respect from a major study done at the University of Pennsylvania, which looked at 72,000 persons who got stents during a nine-month period in 2003. That study also found a reduction in the need for new artery-opening procedures, but it also found a reduction in overall mortality.

You wouldn't necessarily expect a reduction in mortality, because most people don't die of restonosis [reclosing of an artery], Garratt said.

More information

Learn about stents from the U.S. National Library of Medicine.